Article

Systematic review with meta-analysis.
INTRODUCTION: Although
corticosteroid injections are often cited as best practice in the treatment of de
Quervain's disease, no reviews have compared their effectiveness to a multimodal
definition of hand therapy. PURPOSE: To compare the effectiveness of
corticosteroid injections with that of i) hand therapy alone and ii) combined
hand therapy/corticosteroid injection approaches in the treatment of de
Quervain's disease. METHODS: Searches of key databases were performed to identify
experimental studies published between January 1950 and November 2014. Outcome
measures included treatment success, pain, quality of life, and function.
RESULTS: Both corticosteroid injections and hand therapy improved pain and
function from baseline, but between-group differences were not significant
(across 6 studies). However, significantly more participants were treated
successfully when combined orthosis/corticosteroid injection approaches were
compared to i) orthoses (RR 0.53, 95% CI 0.35-0.80) and ii) injections alone (RR
0.76, 95% CI 0.64-0.89). CONCLUSION: Combined orthosis/corticosteroid injection
approaches are more effective than either intervention alone in the treatment of
de Quervain's disease. LEVEL OF EVIDENCE: 1a.
CI - Copyright (c) 2016 Hanley & Belfus. Published by Elsevier Inc. All rights
reserved.

Langue : ANGLAIS